Burden of Liver Cancer in China from 1990 to 2019 and projections to 2044: Findings from the Global Burden of Disease Study

BackgroundChina has the highest liver cancer burden in the world. Prediction and comparison of the future trends of liver cancer in China and some representative areas may guide further control action. MethodsUsing data from the Global Burden of Disease Study, we assessed incidence, mortality, and disability-adjusted life-years of liver cancer in Mainland China, with reference to representative East Asia areas (Taiwan China, Japan, and Korea) and Western areas (the United Kingdom and the United States). The burden of liver cancer was evaluated and predicted using NOREPRED model from 1990 to 2044. ResultsOverall, the liver cancer incidence (28.1 to 10.6 per 100,000) and mortality (27.5 to 9.7 per 100,000) decreased from 1990 to 2015 in Mainland China, which were consistent with the trends of Eastern Asia areas. However, the disease burden in Mainland China were then plateaued and started to increase during 2015-2044 (10.6 to 14.8 per 100,000 for incidence; 9.7 to 14.02 per 100,000 for mortality), including the hepatitis-related liver cancer incidence (increase from 8.6 to 11.7 per 100,000). While the changing patterns of alcohol- and nonalcoholic steatohepatitis (NASH)- related liver cancer incidence were found similar among Mainland China (0.93 to 1.51 per 100,000 for alcohol; 0.5 to 0.73 per 100,000 for NASH) and Western countries in our projection. ConclusionThe liver cancer burden in Mainland China is unexpectedly predicted to increase again after decades of decline. Future efforts must be made to resolve both the remaining hepatitis-related cancer burden and the changing etiologies.